Antoniak, Sandra K
Antoniak, Sandra K is an individual health care provider with primary practice located at 3500 N Sabino Canyon Rd Unit 54 , Tucson AZ 85750-6141. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Forensic Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Antoniak, Sandra K can be contacted via phone (402) 305-1921.Contact Information
Primary practice address
3500 N Sabino Canyon Rd Unit 54
Tucson AZ 85750-6141
Phone: (402) 305-1921
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 266006 | New York |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 266006 | New York |
| Allopathic & Osteopathic Physicians / Forensic Psychiatry | 2084F0202X | 266006 | New York |
Profile Details
| NPI number | 1891992285 |
|---|---|
| LBN Legal business name | Antoniak, Sandra K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2007 |
| Last updated | Dec 3rd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891992285 | NPPES |
| New York | Other | 266006 | LICENSE |
| New York | MEDICAID | 03615758 | LICENSE |
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